Necrotic lymphadenopathy in Epstein –Barr virus-positive diffuse large B-cell lymphoma

An 87-year-old woman presented with a 2-month history of low-grade fever and weight loss. Contrast-enhanced computed tomography (CT) of the neck, chest, abdomen and pelvis revealed generalized lymphadenopathy. Most of the lymph nodes were well-demarcated and had peripheral enhancement (Figure  1A and B, arrows). A cervical lymph node biopsy revealed large lymphoma cells which were positive for CD20, MUM1 and CD30 and negative for CD3 and CD10. Epstein –Barr virus (EBV)-encoded small ribonucleic acidin situ hybridization (EBER ISH) of the large lymphoma cells returned positive. Based on these pathological findings, EBV-positive diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) was diagnosed. After the patient received R-THP-COP therapy, her symptoms and the generalized lymphadenopathy resolved.
Source: QJM - Category: Internal Medicine Source Type: research